Scientific article
Open access

Development of a personalized fall rate prediction model in community-dwelling older adults: a negative binomial regression modelling approach

Published inBMC geriatrics, vol. 23, no. 1, 200
Publication date2023-03-30
First online date2023-03-30

Background: Around a third of adults aged 65 and older fall every year, resulting in unintentional injuries in 30% of the cases. Fractures are a frequent consequence of falls, primarily caused in individuals with decreased bone strength who are unable to cushion their falls. Accordingly, an individual's number of experienced falls has a direct influence on fracture risk. The aim of this study was the development of a statistical model to predict future fall rates using personalized risk predictors.

Methods: In the prospective cohort GERICO, several fall risk factor variables were collected in community-dwelling older adults at two time-points four years apart (T1 and T2). Participants were asked how many falls they experienced during 12 months prior to the examinations. Rate ratios for the number of reported falls at T2 were computed for age, sex, reported fall number at T1, physical performance tests, physical activity level, comorbidity and medication number with negative binomial regression models.

Results: The analysis included 604 participants (male: 122, female: 482) with a median age of 67.90 years at T1. The mean number of falls per person was 1.04 and 0.70 at T1 and T2. The number of reported falls at T1 as a factor variable was the strongest risk factor with an unadjusted rate ratio [RR] of 2.60 for 3 falls (95% confidence interval [CI] 1.54 to 4.37), RR of 2.63 (95% CI 1.06 to 6.54) for 4 falls, and RR of 10.19 (95% CI 6.25 to 16.60) for 5 and more falls, when compared to 0 falls. The cross-validated prediction error was comparable for the global model including all candidate variables and the univariable model including prior fall numbers at T1 as the only predictor.

Conclusion: In the GERICO cohort, the prior fall number as single predictor information for a personalized fall rate is as good as when including further available fall risk factors. Specifically, individuals who have experienced three and more falls are expected to fall multiple times again.

Trial registration: ISRCTN11865958, 13/07/2016, retrospectively registered.

  • Count data
  • Fall rate
  • Falls
  • History of falls
  • Prediction
  • Humans
  • Male
  • Female
  • Aged
  • Prospective Studies
  • Independent Living
  • Fractures, Bone
  • Risk Factors
Citation (ISO format)
WAPP, Christina et al. Development of a personalized fall rate prediction model in community-dwelling older adults: a negative binomial regression modelling approach. In: BMC geriatrics, 2023, vol. 23, n° 1, p. 200. doi: 10.1186/s12877-023-03922-1
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Article (Published version)
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ISSN of the journal1471-2318

Technical informations

Creation04/21/2023 8:37:40 AM
First validation06/05/2023 2:58:24 PM
Update time06/05/2023 2:58:24 PM
Status update06/05/2023 2:58:24 PM
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